The number of anticoagulated patients has been increasing over the years, especially after the introduction of new direct oral anticoagulant (DOAC) drugs, for example, vitamin K antagonists (warfarin), thrombin inhibitor (dabigatran), and factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban).1–3 

The decision to have patients receiving long-term oral anticoagulant therapy to umdergo invasive procedures is still a matter of heated debate in the literature. Should doctors continue, modify, or interrupt anticoagulation intake? It is not a simple question to answer. In general, some factors must be taken into account, such as the type of dental procedure (expected bleeding), medical background (risks of bleeding and thromboembolism), and availability of local and systemic hemostatic measures.

Cessation or reduction of anticoagulants for some days before dental procedures may make patients vulnerable to thromboembolism, especially those at high risk. Therefore, some researchers suggest performing tooth extractions in anticoagulated patients only...

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